O-234 Monitor all parameters

Ovarian stimulation in assisted reproductive technology (ART) is performed with the goal of obtaining multiple follicles and oocytes. To achieve this, FSH (follicle-stimulating hormone) is administered through various types of medications. The stimulation dose is typically determined based on the woman’s ovarian reserve parameters, age, and the specific objectives of the treatment. Normally, during ovarian stimulation (OS), monitoring is carried out to assess the response to the treatment, determine if adjustments to the dose, medication, or treatment plan are necessary, and decide the optimal time for oocyte retrieval. Monitoring is typically performed using ultrasound and/or serum hormone levels. Recent advancements, including GnRH agonist triggering, vitrification, freeze-all for genetic testing, progestin-primed ovarian stimulation (PPOS), random start and luteal phase stimulation are transforming COS protocols and opening new avenues and possibilities. Therefore, whether multiple ultrasound and hormonal assessment are necessary for all patients is a matter of debate, especially considering that nowadays most cycles result in a freeze-all approach (FA). It must be acknowledged that one of the most common questions among nearly all patients who choose to undergo an IVF journey is how much time ovarian stimulation will require. Given that monitoring often requires patients/donors to travel, which may involve taking time off work, the best possible solution would likely be to schedule all monitoring sessions in advance, minimize these visits as much as possible and allow the monitoring to take place at their home. At this point, it is important to ask ourselves whether, given the recent shift in approach toward FA, it still makes sense to apply the same strategy to all patients, or if we can consider personalizing the monitoring. This could involve monitoring all parameters only in patients who will undergo a fresh transfer or those who have had previous cycles with results below expectations. Additionally, a review of the current state of the art regarding the possibility of measuring hormones and performing ultrasounds at home should be conducted.